European Commission - Public Health: healthindicators.org

Health expectancy: Healthy Life Years (HLY)

Definition of indicator

Eurostat structural indicator defined as expected remaining years lived at a particular age without long-term activity limitation. It is computed by the Sullivan method based on life table data and the Euro-REVES General Activity Limitation Indicator (GALI),

Calculation (numerator, denominator)

Computed by the Sullivan method: life tables combined with age-specific period prevalence data on long-term activity limitations (Documentation Sheet 34): Prevalence of persons who answer ‘severely limited’ or ‘limited but not severely’ to the EHIS question HS.3.: “For at least the past 6 months, to what extent you have been limited because of a health problem in activities people usually do? Severely limited / limited but not severely / not limited at all.”

Additional underlying concepts

Can also be called “Life expectancy without activity limitations”, and belongs under the more general concept of “Health Expectancy”. It is one specific health expectancy and others can be calculated based on for example self perceived health or self-reported chronic morbidity.

Healthy Life Years is a different concept to the Health-Adjusted Life Expectancy (HALE, number of expected years of life equivalent to years lived in full health) or Disability-Adjusted Life Expectancy (DALE, which use disability weights in the calculation, thus part of the life expectancy with disability is added to disability free life expectancy to obtain the latter), which are based on quite different premises and calculations.

Relevant dimensions (subgroups)

Country (also region), calendar year, gender, age (at birth and at age 65).

Preferred data sources

Healthy Life Years: Eurostat and European Health Expectancy Monitoring Unit, EHEMU.

Mortality: Age-specific mortality (probability of dying between exact ages x and x+5)) and life tables from official national demographic and mortality statistics.

Morbidity: currently EU-SILC. In the future EHIS.

Rationale

Eurostat structural indicator Healthy Life Years (HLY). Health Expectancies extend the concept of life expectancy to morbidity and disability in order to assess the quality of years lived. It is a composite indicator of health that takes into account both mortality and ill-health, providing more information on burden of diseases in the population than life expectancy alone. Monitoring time trend of life expectancy and healthy life years together allows to assess whether years of life gained are healthy years or not.

Data availability, quality and periodicity

Healthy Life Years: Eurostat and EHEMU databases: HLY based on EU-SILC was recently made available in the Eurostat database (structural indicators on health) and added to the HLY for 1995-2003. For calculating these HLY, data on activity limitations were obtained from the ECHP (European Community Household Panel) for the years 1995-2001 for EU-15 Member States (excl. Luxembourg) and extrapolated for 2002-2003. EU-SILC has been used for the year 2004 and onwards. The change of the data source in 2004 created a break in series.

Mortality: Eurostat, WHO, OECD: Age-specific mortality (probability of dying between exact ages x and x+5) and life tables from demographic statistics. Original source is usually the National Statistical Office. See the documentation sheet for ‘life expectancy’ for details.

Morbidity: Eurostat, WHO, (OECD) databases: based on EU-SILC or national HIS. EU-SILC data recently made available in the Eurostat database.

EHIS implemented 2007-2009. Data will thus be available in the coming years (and will be pooled by Eurostat).

References

- European Health Expectancy Monitoring Unit, EHEMU

- Eurostat - Statistics database

- EU-SILC, documents

- HIS-round 2004 and EU-SILC 2004 data

- EHIS standard questionnaire (version of 11/2006)

The EUPHIX (European Union Public Health Information & Knowledge System, www.euphix.org); the Health Status chapter dedicates a topic on health expectancy among Summary measures

Work to do

Decide on the name of the indicator: name changed from “Health expectancy, based on limitations of usual activities“ to “Healthy Life Years (HLY)” as suggested by APS. OK?